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Protective effect of total and supplemental vitamin C intake on the risk of hip fracture—a 17-year follow-up from the Framingham Osteoporosis Study

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Abstract

Summary

Vitamin C may play a role in bone health. In the Framingham Study, subjects with higher total or supplemental vitamin C intake had fewer hip fractures and non-vertebral fractures as compared to subjects with lower intakes. Therefore, vitamin C may have a protective effect on bone health in older adults.

Introduction

Dietary antioxidants such as vitamin C may play a role in bone health. We evaluated associations of vitamin C intake (total, dietary, and supplemental) with incident hip fracture and non-vertebral osteoporotic fracture, over a 15- to 17-year follow-up, in the Framingham Osteoporosis Study.

Methods

Three hundred and sixty-six men and 592 women (mean age 75 ± 5 years) completed a food frequency questionnaire (FFQ) in 1988–1989 and were followed for non-vertebral fracture until 2003 and hip fracture until 2005. Tertiles of vitamin C intake were created from estimates obtained using the Willett FFQ, after adjusting for total energy (residual method). Hazard ratios were estimated using Cox-proportional hazards regression, adjusting for covariates.

Results

Over follow-up 100 hip fractures occurred. Subjects in the highest tertile of total vitamin C intake had significantly fewer hip fractures (P trend = 0.04) and non-vertebral fractures (P trend = 0.05) compared to subjects in the lowest tertile of intake. Subjects in the highest category of supplemental vitamin C intake had significantly fewer hip fractures (P trend = 0.02) and non-vertebral fractures (P trend = 0.07) compared to non-supplement users. Dietary vitamin C intake was not associated with fracture risk (all P > 0.22).

Conclusion

These results suggest a possible protective effect of vitamin C on bone health in older adults.

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Funding sources

This study was supported by the United States Department of Agriculture, Agriculture Research Services agreement number 58-1950-7-707; Framingham Osteoporosis grant number R01 AR/AG 41398; and the NHLBI’s Framingham study contract grant number N01-HC-25195.

Conflicts of interest

None.

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Authors and Affiliations

  1. Dietary Assessment and Epidemiology Research Program, Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) and Friedman School of Nutrition Science and Policy (FSNSP), Tufts University, Boston, MA, USA

    S. Sahni & K. L. Tucker

  2. Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School, Boston, MA, USA

    M. T. Hannan & D. P. Kiel

  3. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    D. Gagnon & L. A. Cupples

  4. Antioxidants Research Laboratory, HNRCA and FSNSP, Tufts University, Boston, MA, USA

    J. Blumberg

  5. Dietary Assessment and Epidemiology Research Program, Jean Mayer USDA HNRCA, Tufts University, 711 Washington Street, Boston, MA, 02111-1524, USA

    K. L. Tucker

Authors
  1. S. Sahni
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  2. M. T. Hannan
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  3. D. Gagnon
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  4. J. Blumberg
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  5. L. A. Cupples
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  6. D. P. Kiel
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  7. K. L. Tucker
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Corresponding author

Correspondence to K. L. Tucker.

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Sahni, S., Hannan, M.T., Gagnon, D. et al. Protective effect of total and supplemental vitamin C intake on the risk of hip fracture—a 17-year follow-up from the Framingham Osteoporosis Study. Osteoporos Int 20, 1853–1861 (2009). https://doi.org/10.1007/s00198-009-0897-y

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  • DOI: https://doi.org/10.1007/s00198-009-0897-y

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